Pain, Aches and Discomfort

Pain is a very personal experience and nobody else can understand exactly how you feel when you have pain. This means you are actually the most important person in making sure your pain is kept under control as you are the one who can tell your medical team how it feels, what makes it worse, when it gets better and what it prevents you from doing. Even if you have only mild pain or discomfort which you think you can cope with, if it is not managed quickly sometimes it can become very difficult to control. Having pain can make things harder for you, both emotionally and physically. If your pain is well controlled you should enjoy a better overall quality of life.

Medication

If you have been prescribed painkillers (also known as analgesics) by your doctor, take the dose that you have been recommended as soon as you first feel you have pain.

Even if you have only mild pain or discomfort which you think you can cope with, make sure that you take painkillers as it is easier to prevent pain than to treat existing pain. Do not exceed the maximum daily dose that you have been prescribed.

If you have pain but have not been prescribed any painkillers, there are certain painkillers that you can take which can be bought without a prescription.

Painkillers suitable for mild pain include:

Paracetamol

It is very important that you do not take more than 8 normal strength Paracetamol tablets (500mg each) in 24 hours. Doses of paracetamol must be at least 4 hours apart.

Caution

Do not take paracetamol if you are allergic to paracetamol.

Many over the counter medicines such as cough, cold and flu remedies and other types of painkiller (such as co-codamol and co-dydramol) also contain paracetamol.

If you are already taking paracetamol, do not take any other medication that contains paracetamol.

Ibuprofen

It is very important that you do not take more than 6 normal strength ibuprofen tablets (200mg each) in 24 hours without medical advice. Doses of ibuprofen must be at least 4 hours apart.

Caution

Do not take ibuprofen if:

You are allergic to aspirin or other non-steroidal anti-inflammatory drugs (NSAID) such as aspirin, Diclofenac, Indomethacin, Mefenamic acid, Meloxicam, Naproxen or Piroxicam.

You have a peptic ulcer (an ulcer anywhere in the digestive system or stomach such as a duodenal ulcer or gastric ulcer).

You have asthma that gets worse when you take ibuprofen, aspirin or other non-steroidal anti-inflammatory drugs (NSAID).

You have severe heart failure.

You have high blood pressure (hypertension) – only take ibuprofen if your blood pressure is controlled.

You have kidney problems – only take ibuprofen if advised by your doctor.

You are taking another non-steroidal anti-inflammatory drug (NSAID).

You are taking any of the following medicines – cyclosporin, lithium, methotrexate, tacrolimus, warfarin.

Many over the counter medicines such as cough, cold and flu remedies and other types of painkiller (such as gels, sprays and mousses that are applied to the skin) also contain ibuprofen. If you are already taking ibuprofen, do not take any other medication that contains ibuprofen.

Fears About Taking Painkillers

Some people are reluctant to take painkillers because they have fears and worries about doing so. This usually results in their pain not being controlled. You should not worry about taking painkillers when you have pain as it is important to get it under control. Taking painkillers is not a sign that you are weak or giving in. Many people who suffer from chronic pain take painkillers for years to control their condition, without experiencing problems.

Fear of Addiction

It is uncommon for people with cancer pain to become addicted to their painkillers. Taking painkillers to control physical pain is not the same as someone choosing to take painkillers because they have a psychological need to feel disconnected or ‘high’. Any medication given to you by your GP or hospital medical team will be appropriately prescribed. As long as you take your painkillers properly as prescribed then you are unlikely to experience a psychological ‘high’ from them (even with stronger painkillers) or become addicted to them.

Fear of Side Effects

As with any type of drug, painkillers do carry potential side effects. Some possible side effects of common painkillers can include:

Nausea (feeling sick).

Vomiting (being sick).

Dyspepsia (indigestion).

Pains in the abdomen (stomach/intestines).

Constipation (difficulty in opening your bowels).

Feeling light headed.

Stronger painkillers (opioid painkillers) can also cause other side effects from those listed above. These can include:

Drowsiness.

Feeling tired.

Dry mouth.

You may not necessarily experience all or even any of these side effects, and the side effects of opioid painkillers will normally settle over time. If you do experience any of these side effects and they become a problem for you, please contact your medical team as they may suggest adjusting the dose or trying a different type of painkiller which may suit you better.

Tips for Coping with Pain

There are lots of things that you can do by yourself or with the help of a friend or relative that may help you to cope with pain.

Get Comfortable

The way that you sit or lie down can affect any pain that you may be experiencing. Sometimes you may find that you need to change position to keep comfortable. Ask your family or friends to help with this if you struggle to change position easily.

Hot and Cold

Using heat pads and taking warm baths can help to relax muscles, reduce joint stiffness and help to relieve general aches and pains.

Ice packs can help to relieve pain where you have any inflammation or swelling.

Be careful not to put heat pads or ice packs directly on to your skin. Always make sure you wrap them in a towel (or something similar) first before you place them near your skin. Never use heat on body areas that are already inflamed or swollen as it can make the swelling worse. If you are suffering from pins and needles in your fingers and toes be especially careful with hot and cold.